Opioid Drug Interactions Flashcards Preview

Clinical Pharmacology > Opioid Drug Interactions > Flashcards

Flashcards in Opioid Drug Interactions Deck (12)
Loading flashcards...
1

Opioid Absorption

-Well absorbed from SQ, IM, transdermal, and mucosal surfaces

-Most have extensive 1st pass metabolism

-Low bioavailability overall

2

Absorption interactions

-delay gastric emptying & absorption of many orally administered drugs (especially platelet inhibitors)

3

CYP3A4 Substrates

-Oxycodone (major)
-Hydrocodone (major)
-fentanyl (major)
-buprenorphine
-tramadol (major)

***All of these are contraindicated with Clarithromycin

4

CYP2D6 Substrates (Major)

-Codeine (major)
-Tramadol (major)
-Oxycodone (minor)
-Hydrocodone (minor)

-Potent CYP2D6 inhibitors will prevent these drugs from being converted
-Ultra-rapid metabolizers may have issues with OD

5

Opioids with essentially no CYP interaction

-Hydromorphone
-oxymorphone
-Morphine

**more predictable in patients with CYP2D6 polymorphisms

6

Mu Receptor

-analgesia, euphoria, respiratory depression, physical dependence properties

7

Opioid additive interactions

-Additive analgesia with APAP/NSAIDs --> GOOD!

-Increased sedation with other sedatives/hypnotics --> BAD!

8

All Opioids have a black box warning regarding what class of drugs?

Benzos

9

Which drug class is contraindicated with or within 14 days of using an opioid?

MAOI

****All products contraindicated

10

What two opioids put patients at risk for serotonin syndrome when combined with other serotonergic drugs?

-Tramadol
-Fentanyl

11

What is a common result of mixing opioids and anticholinergic drugs?

Constipation

12

Which two opioids increase the risk of seizures if combined with bupropion, SSRI/SNRI, TCA, or antipsychotics?

-Tramadol
-Tapentadol